Petition for A Student Chapter

Fill out the following form and send it to the membership and activities board.

To: ACM Chief Operating Officer
From: The Proposed Student Chapter of the ACM
Date: __ / __ / __

Re: Petition for recognition of our Chapter to be known as:

Name:

Address:

Phone:

Email:

We request recognition as an official Student Chapter of the ACM, andapproval of the bylaws which are attached. Below are the names of at least three officers which are at this time members or are including a membership application herewith, as well as the signatures of at least ten students interested in joining the Chapter.

Member No. __________________ or Member application attached
Name
Office

Member No. __________________ or Member application attached
Name
Office

Member No. __________________ or Member application attached
Name
Office

Member No. __________________ or Member application attached
Name
Office

Sponsor Name
Member No. __________________ or Member application attached

If Charter is granted, the next election date for these officers will be held on: Month_______ Year_______